2-Appendix A Acknowledgement of Receipt Form.pdf
PDF 113 KB Posted
- Attached to
- All Payers Claims Database State and local contract opportunity
- Solicitation number
- 26-665-3030-78227
- Issued by
- New Mexico
About this file
This document is an Acknowledgement of Receipt Form for a Request for Proposal (RFP) issued by the New Mexico Department of Health for an All Payers Claims Database with the procurement number 26-665-3030-78227. The form is an optional document that allows potential offerors to be included on a distribution list to receive written responses to questions and any amendments to the RFP. Potential offerors who do not return this form will be responsible for obtaining information from the Procurement Library and will not be automatically notified of updates.
The form requires interested organizations to provide key contact information, including organization name, contact name, title, phone number, email address, and physical address. The completed form should be submitted via email to Adriana Padilla at Adriana.padilla@doh.nm.gov, with the subject line "All payers Claims Database, #26-665-3030-78227". While submitting the form is optional, it is recommended to ensure timely communication and receipt of important RFP-related information.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 6-Appendix E Organizational Reference Questionnaire.pdf | ||
| 8-Appendix G Cost Response Form.pdf | ||
| 5-Appendix D Letter of Tansmittal Form.pdf | ||
| 7-Appendix F Detailed Scope of Work.pdf | ||
| 11-Appendix J Client List Form.pdf | ||
| 12-Pre-Proposal Conference Link.pdf | ||
| 1-26-665-3030-78227 All Payers Claims Database.pdf | ||
| 10-Appendix I System Hosting Evaluation Questionnaire.pdf | ||
| 3-Appendix B Campaign Contribution Disclosure Form.pdf | ||
| 4-Appendix C Draft Agreement.pdf | ||
| 9-Appendix H Information Technology Requirements.pdf |
Show all 11
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Text version
APPENDIX A
ACKNOWLEDGEMENT OF RECEIPT FORM
REQUEST FOR PROPOSAL
All Payers Claims Database 26-665-3030-78227
ACKNOWLEDGEMENT OF RECEIPT FORM
This optional Acknowledgement of Receipt Form establishes a distribution list to be used for the distribution of written responses to questions, and/or any amendments to the RFP. Failure to return the Acknowledgement of Receipt Form does not prohibit potential Offerors from submitting a response to this RFP. However, by not returning the Acknowledgement of Receipt Form, the potential Offeror’s representative shall not be included on the distribution list, and will be solely responsible for obtaining from the Procurement Library (Section I.G.) responses to written questions and any amendments to the RFP.
The information below will be used for all correspondence related to the Request for Proposal.
Only one contact per Offeror is permitted.
ORGANIZATION:
CONTACT NAME:
TITLE: ________________________________ PHONE NO.: ____________________
E-MAIL: __________________________________________
ADDRESS: _____________________________________________________________
CITY: __________________________ STATE: ________ ZIP CODE: _____________
Submit Acknowledgement of Receipt Form to:
To: Adriana Padilla
E-mail: Adriana.padilla@doh.nm.gov Subject Line: All payers Claims Database, #26-665-3030-78227 mailto:Adriana.padilla@doh.nm.gov
File details come from the government source that posted it. Updated .